Post-Surgery Anal Bumps: Hemorrhoids or Keloids? - Surgery

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After undergoing a minimally invasive hemorrhoidectomy for the removal of internal and external hemorrhoids, it is not uncommon for patients to experience residual bumps or lumps around the anal area. In your case, it has been seven months since the surgery, and you are still feeling a lump at the anal opening, along with some pain during prolonged sitting or standing, although there is no bleeding during bowel movements.
Firstly, let's clarify the potential causes of the lump you are feeling. The two most common possibilities are recurrent hemorrhoids or keloids (also known as hypertrophic scars).
1. Recurrent Hemorrhoids: Hemorrhoids can recur after surgical intervention, especially if there are underlying factors such as chronic constipation, straining during bowel movements, or prolonged sitting. If the initial surgery did not completely remove all the hemorrhoidal tissue, it is possible for hemorrhoids to redevelop. Symptoms of recurrent hemorrhoids can include a lump, discomfort, and sometimes bleeding, although you mentioned that you are not experiencing bleeding during bowel movements currently.

2. Keloids or Hypertrophic Scars: Keloids are a type of raised scar that can occur after surgery, particularly in individuals who are predisposed to keloid formation. They can develop when the body produces excess collagen during the healing process. If the lump you are feeling is indeed a keloid, it may not be painful unless it is subjected to pressure or irritation. Keloids can be persistent and may recur even after surgical removal, which is a significant consideration if you are contemplating further surgical intervention.

Given your symptoms, it is essential to consult with your healthcare provider or a specialist in colorectal surgery. They can perform a thorough examination to determine the nature of the lump. They may use visual inspection and possibly imaging studies to assess the area more accurately.
If it is determined that the lump is indeed a recurrent hemorrhoid, treatment options may include non-surgical methods such as rubber band ligation, sclerotherapy, or infrared coagulation. If it is a keloid, treatment options may include corticosteroid injections, silicone gel sheets, or in some cases, surgical excision followed by additional treatments to minimize recurrence.

In terms of your concerns about pain during prolonged sitting or standing, this could be related to several factors, including muscle tension, irritation of the surrounding tissues, or even nerve-related issues. It is advisable to discuss these symptoms with your doctor, who may recommend lifestyle modifications, pain management strategies, or physical therapy to alleviate discomfort.

In conclusion, while it is possible that you are experiencing either recurrent hemorrhoids or a keloid, a definitive diagnosis can only be made through a clinical evaluation. It is crucial to address these concerns with your healthcare provider to ensure appropriate management and to prevent further complications. Regular follow-ups and open communication with your healthcare team are vital for your recovery and overall well-being.